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General NPI Number Information
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NPI Number | 1710244850
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Entity Type | Individual
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Provider Name | KEITH MICHAEL STRATTAN L.P., C.P.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 4421 19TH ST
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City | LUBBOCK
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State | TX
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Zip | 79407-2408
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Country | US
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Telephone | 806-799-1518
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Fax | 806-799-5462
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Provider Business Mailing Address
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Address Line | 4421 19TH ST
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City | LUBBOCK
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State | TX
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Zip | 79407-2408
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Country | US
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Telephone | 806-799-1518
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Fax | 806-799-5462
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | 251
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License Number State | TX
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